Buiteman-Kruizinga L.A.Neto A.S.Botta M.List S.S.de Boer B.H.van Velzen P.Bühler P.K.Wendel Garcia P.D.Schultz M.J.van der Heiden P.L.J.Paulus F.Appel R.J.A.van den Berg A.Bierlee M.C.W.M.Boezaart D.Boots J.A.Bosman B.Bühler P.Fehlbier K.J.Goossen R.L.Guseva A.A.Hoekstra-Kapitein C.Kleinert E.M.Last H.van Leijsen T.D.Luttmer-Laven M.Remmerswaal L.Schriel-Van den Berg Y.Sinnige J.S.Tsonas A.M.Vermeulen T.Mahidol University2024-08-052024-08-052024-07-01PLoS ONE Vol.19 No.7 July (2024)https://repository.li.mahidol.ac.th/handle/20.500.14594/100238Introduction Mechanical power of ventilation, a summary parameter reflecting the energy transferred from the ventilator to the respiratory system, has associations with outcomes. INTELLiVENT-Adaptive Support Ventilation is an automated ventilation mode that changes ventilator settings according to algorithms that target a low work-and force of breathing. The study aims to compare mechanical power between automated ventilation by means of INTELLiVENT-Adaptive Support Ventilation and conventional ventilation in critically ill patients. Materials and methods International, multicenter, randomized crossover clinical trial in patients that were expected to need invasive ventilation > 24 hours. Patients were randomly assigned to start with a 3-hour period of automated ventilation or conventional ventilation after which the alternate ventilation mode was selected. The primary outcome was mechanical power in passive and active patients; secondary outcomes included key ventilator settings and ventilatory parameters that affect mechanical power. Results A total of 96 patients were randomized. Median mechanical power was not different between automated and conventional ventilation (15.8 [11.5-21.0] versus 16.1 [10.9-22.6] J/min; mean difference -0.44 (95%-CI -1.17 to 0.29) J/min; P = 0.24). Subgroup analyses showed that mechanical power was lower with automated ventilation in passive patients, 16.9 [12.5-22.1] versus 19.0 [14.1-25.0] J/min; mean difference -1.76 (95%-CI -2.47 to - 10.34J/min; P < 0.01), and not in active patients (14.6 [11.0-20.3] vs 14.1 [10.1-21.3] J/min; mean difference 0.81 (95%-CI -2.13 to 0.49) J/min; P = 0.23). Conclusions In this cohort of unselected critically ill invasively ventilated patients, automated ventilation by means of INTELLiVENT-Adaptive Support Ventilation did not reduce mechanical power. A reduction in mechanical power was only seen in passive patients.MultidisciplinaryArticleSCOPUS10.1371/journal.pone.03071552-s2.0-8519994093519326203